Citation Nr: 21067566 Decision Date: 11/04/21 Archive Date: 11/04/21 DOCKET NO. 18-52 576 DATE: November 4, 2021 REMANDED Entitlement to an evaluation higher than 10 percent for left knee limitation of motion is remanded. REASONS FOR REMAND The Veteran served in the United States Army from May 1968 to January 1970, including service in the Republic of Vietnam. Among many decorations, the Veteran was awarded the Silver Star, Army Commendation Medal with V device, Vietnam Campaign Medal, Bronze Star with V device, and a Purple Heart Medal. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a June 2016 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In a January 2020 decision, the Board denied entitlement to an evaluation higher than 10 percent for left knee arthritis with painful motion. The Veteran appealed that portion of the January 2020 decision to the United States Court of Appeals for Veterans Claims (Court). In a November 2020 Order, the Court granted a joint motion for partial remand (JMPR) submitted by the parties and vacated and remanded the January 2020 left knee increased rating claim back to the Board. In May 2021, the Board remanded the matter for action consistent with the November 2020 Order, including obtaining an adequate VA examination. Unfortunately, remand is again required. The Board is obligated by law to ensure that the RO complies with its directives. Stegall v. West, 11 Vet. App. 268, 271 (1998). Entitlement to an evaluation higher than 10 percent for left knee limitation of motion is remanded. As discussed in the JMPR, a September 2018 VA examiner noted pain on all ranges of motion that resulted in functional loss, but the examiner did not note whether the Veteran's pain began during his range of motion. The examiner also found that the Veteran's range of motion contributed to functional loss because of pain, and it was unclear whether the examiner's range of motion measurements took into account the loss of range of motion due to pain. Also, the examiner did not note the range of motion on weight-bearing and passive range of motion. The JMPR explained that on remand, to the extent the Board relies on any other examination that does not indicate the results of testing of ROM in passive, active, weight-bearing, and non-weight-bearing modes, the Board must explain how the Board's analysis is nevertheless able to capture the required aspects of disability. The Veteran underwent another VA examination in June 2021. The examiner captured all the required ranges of motion and found that there was no report of flare-ups or pain at that examination. The Veteran endorsed symptoms of residual pain and weakness with prolonged mobility. The pain came and went and was worse with cold weather. The Veteran endorsed additional functional loss of the left knee with repetitive use over time, described as limitations with walking, squatting, or bending over for prolonged periods. On examination, the Veteran was able to perform repetitive use testing with at least 3 repetitions without additional loss of function or range of motion. The examiner found that pain, fatigability, weakness, lack of endurance, or incoordination did not significantly limit functional ability with repeated use over time, but the examiner failed to explain this finding given the Veteran's lay testimony of limitations with walking, squatting, and bending with repeated use over time and weakness with prolonged mobility. Thus, the examination is not wholly adequate and remand is again required. The matters are REMANDED for the following action: 1. Return the file to the VA examiner who provided the June 2021 examination. Ask the examiner to explain how the Veteran's reports of limitations with walking, squatting, and bending with repeated use over time and weakness with prolonged mobility were considered in forming his opinion that that pain, fatigability, weakness, lack of endurance, or incoordination did not significantly limit functional ability with repeated use over time. The examiner should provide a clear conclusion with supporting data, and reasoned medical explanation connecting the two. LAURA E. COLLINS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Smith, Counsel The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.